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2. If you've scheduled an appointment, please note the date/time:
   If you've scheduled an appointment, please note the date/time:

   If you've scheduled an appointment, please note the date/time:

   You can make an appointment by calling us at 908-788-1156.

4. Name of Decedent:*

   As stated in Will. 

5. Alternate Name(s) of Decedent:*

   Name as listed on the death certificate, driver's license, accounts, etc.  

6. Age of Decedent:*
8. FULL Address of Decedent:*

   Where the decedent physically resided at time of death. Include zip code. 

9. Township/Borough:*

   Where were taxes paid to?

11. Has an attorney been retained to assist with the estate?*

    1. Yes
    2. No
13. Attorney Name:*
14. Attorney Phone:*
16. Attorney Mailing Address:*
17. Attorney Email:*
19. Administrator Name:*
20. Relation to Decedent:*
22. Administrator Address:*

    Include zip code; NO PO Box

23. Administrator SSN:*
24. Administrator Phone:*
25. Administrator Email:*
27. Is a co-administrator applying?*

    1. Yes
    2. No
29. Co-Admin Name:*
30. Relation to Decedent:*
32. Co-Admin Address:*

    Include zip code; NO PO Box

33. Co-Admin Phone:*
34. Co-Admin SSN:*
35. Co-Admin Email:*
37. The decedent's death was the result of:*

    EX. medical malpractice, car accident, recklessness, etc.  (the basis of your lawsuit) 

39. The injury occurred in:*

    Specific location of injury including county and state.

41. Name and full address of each party being sued:*
45. NEXT OF KIN NAME / RELATION / ADDRESS / AGE (if minor):

    Include name, relation to decedent, and FULL address. Include age only if under 18.

    Decedent's closest next of kin (starting with spouse and children) must be listed here, regardless of whether they are beneficiaries or not, estranged, etc. You MUST provide their addresses.

    Start with spouse and children.  If there are no spouse or children, list grandchildren.  If there are only parents living, list parents.  If there are only siblings living, list siblings.  ETC. 

47. DOUBLE-CHECK: Did you put the relation AND address for each next of kin listed above and notate age of minors?*

    1. Yes
49. If the decedent was your spouse, are the children listed above also your children?*

    1. Yes
    2. No
    3. Some of them
    4. N/A
51. Did the decedent have any children who died?*

    1. Yes
    2. No
53. Deceased Child Information *

    List the deceased child's name and year of death. 
    If the deceased child had children, you must list those children's name(s) and full addresses here.  List ages only if under 18.  
    Please be as clear as possible. 

55. ASSET INFORMATION

    You must supply asset and value information for Administrations.  
    List assets that have NO beneficiaries listed.

57. Real Estate

    Please list the property address, its current market value, and whether it is jointly owned.  

59. Titled Vehicles

    List the year/make/model and current Kelly Blue Book value of cars, trucks, trailers, planes, boats, etc.  

61. Bank Accounts

    List financial institution, type of account, current value, and whether the asset is jointly owned.  

63. Stocks/Bonds (with NO beneficiaries)

    List financial institution, type of account, current value, and whether the asset is jointly owned.  

65. Life Insurance Policies (with NO beneficiaries)

    List financial institution/company and current value.

67. Safe Deposit Box

    List bank where box is located and value of contents (if known).

69. Personal Property with SIGNIFICANT value:
71. UPLOAD DEATH CERTIFICATE:

    Please upload a copy of the death certificate here.  You must present the ORIGINAL death certificate to the Court at the time of administration. 

73. NOTE ABOUT FEES:

    The cost for an Administration Ad Prosequendum is $50 and is payable via cash, check, Visa, Mastercard, or Discover card.  We cannot accept a check with the decedent's name on it unless it is from a joint spousal account.    

75. Do you have any questions for us or is there anything else you'd like us to know?
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77. 1. Receive an email copy of this form.
78. Email address

    This field is not part of the form submission.

79. Submit

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